Korean J Orthod.  2022 Jul;52(4):308-312. 10.4041/kjod21.238.

Split orthodontic airway plate: An innovation to the utilization method of conventional orthodontic airway plate for neonates with Robin sequence

• Choo H
• Kim SH
• Ahn HW
• Poets CF
• Chung KR

• KMID: 2532154
• DOI: http://doi.org/10.4041/kjod21.238

Abstract

Since the emergence of neonatal infant orthodontics for treatments of cleft lip and palate with or without Robin sequence (RS) in Europe in the 1950s, advancements in design and scope of its application have been remarkable. As the first institution to adopt orthodontic airway plate (OAP) treatment in the United States in 2019, we saw a need for innovation of the original design to streamline the most labor-intensive and time-consuming aspects of OAP utilization. A solution is introduced using a systematic split expansion mechanism to re-size the OAP periodically to accommodate the neonate’s maxillary growth. To date, seven RS patients have received this modified treatment protocol at our institution. Each patient completed full treatment using only one OAP. This innovative utilization method is aptly named the split orthodontic airway plate (S-OAP). Details of the S-OAP and its modifications from conventional OAP are reported.

Keyword

Airway; Craniofacial anomalies; Cleft lip and palate; Infant obstructive sleep apnea

Figure

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  Figure 1 Conventional orthodontic airway plate (OAP). A, Schematic illustration of the oropharyngeal structure of a neonate with Robin sequence showing upper airway obstruction resulting from glossoptosis; maxilla (Mx), mandible (Mn), tongue (T), and airway (A). B, Lateral view of an OAP showing the extraoral, palatal, and pharyngeal components. C, Schematic illustration with an OAP inside the mouth. The black arrow in A and C indicates the proximity of the tongue relative to the posterior pharyngeal wall. Enlarged pharyngeal airway by an OAP is noticeable.

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  Figure 2 Split orthodontic airway plate (S-OAP). A, A mini-expansion screw is embedded at the center of the palatal component of an orthodontic airway plate (OAP). B, The S-OAP is split in half and the expansion screw is activated to enlarge the OAP. C, The enlarged split is re-unified by fresh splint acrylic. D, An example of the facial frontal view of a 3-month-old infant with Robin sequence wearing a S-OAP connected to facial tapes. Photos are used with the written consent from the patient.

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  Figure 3 An exemplary patient with isolated Robin sequence whose orthodontic airway plate treatment was completed using one split orthodontic airway plate (S-OAP) during the 6 months of treatment. A, On the day of the S-OAP delivery at the age of 5 weeks. B, 6 months after wearing the S-OAP requiring no further use of the S-OAP for feeding and breathing difficulties. C, Pre-treatment intraoral photo of the maxillary arch. D, Post-treatment intraoral photo. Photos are used with the written consent from the patient.

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